TESTS AND PROCEDURES

Mastectomy

By Hitt, Emma 
 | 
February 09, 2018

Mastectomy

Mastectomy is surgery to remove the breast. The most common mastectomies are called simple (or total) mastectomy and modified radical mastectomy. During these procedures, the chest muscle under the breast is not removed. As a result, arm strength remains. Keeping the chest muscle also makes reconstruction easier.

Three-quarter view of female underarm area showing breast anatomy ghosted in. Outline around tissue for simple mastectomy.

Three-quarter view of female underarm area showing breast anatomy ghosted in. Dotted line shows tissue and lymph nodes removed in modified radical mastectomy.

Simple (total) mastectomy

During a simple mastectomy, the breast tissue (lobules, ducts, and fatty tissue) and the nipple are removed. This surgery most often needs a hospital stay. Based on the results of surgery and follow-up tests, more treatment may be needed.

Modified radical mastectomy

This type of mastectomy is usually done to treat invasive cancer that has spread to the lymph nodes. During the procedure, the breast tissue and a strip of skin with the nipple are removed. Some of the lymph nodes under the arm are also removed. (These are lymph nodes in the arm pit.) The removed nodes are tested for cancer. Sometimes a surgical drain is used to keep fluid from building up. This drain usually stays in for 1 to 2 weeks after surgery. Modified radical mastectomy almost always needs a hospital stay. Based on the results of the surgery and follow-up tests, more treatment may also be needed.

Right after surgery

You will wake up in the recovery room. You may have an IV (intravenous) line for fluids and medicines. You will have a tight bandage (dressing) wrapped around your chest. There may also be a drain coming out of it. Pain medicines will be given to you as needed. A nurse will check your temperature, pulse, and blood pressure. You'll likely stay in the hospital for at least a day.

You will be given instructions on how to care for the dressing and drains, what kind of pain medicines you should use, and how to take care of yourself as you recover. You may be given arm exercises to do as you heal. Make sure you understand all the instructions and know when you need to next see your healthcare provider.

Risks and complications of mastectomy

Any type of surgery has some risk. Risks for mastectomy with reconstruction include:

  • Pain or numbness

  • Bleeding or infection

  • Swelling at the breast area

  • Stiffness of the shoulder

  • Fluid collection (seroma) in the area where the tumor was removed

  • Long-term swelling of the hand and arm (lymphedema)

  • Wound-healing problems and scarring

Talk with your healthcare provider about the risks related to your surgery and what you can do to help prevent problems.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following after surgery:

  • Fever

  • Chills

  • A change in the way the drainage looks or increased drainage

  • Increased pain, warmth, swelling, or redness at the incision

  • Cough or shortness of breath

  • Pain in the chest or calf

  • Bleeding that soaks the dressing

  • Any other problems your healthcare providers told you to watch for and report

Make sure you know how to reach your healthcare provider in case problems come up. Know what number to call with questions or problems after office hours, on weekends, and on holidays, too. 

Updated:  

February 09, 2018

Sources:  

Mastectomy, UpToDate

Reviewed By:  

Cunningham, Louise, RN,Image reviewed by StayWell medical illustration team.,Stump-Sutliff, Kim, RN, MSN, AOCNS